Nursing numbers fail to keep pace with growing need and losses to profession

Colleen Risley, a nurse at WellSpan York Hospital talks about why she got into nursing and the demand for nurses.
Paul Kuehnel, pkuehnel@ydr.com

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First year nursing students Tori Hopkins, left, and Takishia Lee, right, practice an examination in Southern Miss' nursing program. Takisha Lee knew there was a nursing shortage in Mississippi when she chose the profession, but says she got into the field to help people.
(Photo: Susan Broadbridge/Hattiesburg American)Buy Photo

Tori Hopkins knows why she finds herself in the first-year nursing program at the University of Southern Mississippi.

"To help people — make the world a better place," she said. "It's something I've always wanted to do."

But the many jobs available in her field after she finishes her two years of nursing courses don't hurt either.

"I know the need is going up," Hopkins said. "The career opportunities are exciting."

Talk to anybody in the nursing domain and they'll tell you — nurses are needed.

"The number of registered nurses is expected to grow 16 percent by 2024, but that's not going to keep pace with the numbers lost," said Lachel Story, associate dean at Southern Miss' College of Nursing. "There is an RN shortage in this country."

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Gateway Technical College Dean of Nursing Vicki Hulback (left) observes nursing student Brian Smith take the temperature of Apollo, a patient simulator that talks, has a heartbeat and a pulse, and opens and closes his eyes. Technical colleges and four-year colleges are partnering to help hospitals get more nurses who have bachelor of science degrees in nursing. Angela Peterson / Milwaukee Journal Sentinel

Apollo, a patient simulator that talks, has a heart beat and a pulse, and opens and closes his eyes, is used to help nursing students learn at Gateway Technical College. Angela Peterson / Milwaukee Journal Sentinel

Brian Smith, a former emergency medical technician in Kenosha, is a nursing student at Gateway Technical College in a fast-track program that partners with Cardinal Stritch University. Angela Peterson / Milwaukee Journal Sentinel

But the bureau also predicts the need for more than 649,000 replacement nurses, bringing the total number of job openings for nurses because of growth and replacements to more than 1 million by 2024.

Numbers specific to Mississippi are hard to come by, but the American Journal of Medical Quality reports a shortage of registered nurses is projected to spread across the country between 2009 and 2030. The authors forecast the RN shortage to be most intense in the South and West.

Story said there is a particular shortage of psychiatric mental health nurses, nurse practitioners and nurse anesthetists, with all affecting Mississippi, especially the last two categories.

"There's also a (nursing) faculty shortage, which compounds all the other shortages," Story said. "All are going to impact patient care."

Higher nurse-to-patient staffing ratios can adversely affect the rate of patient infections and mortality, length of hospital stay and lead to nurse burnout, according to several studies.

Though it may not be widely reported, there's no doubt there's a nursing shortage in Mississippi, Story said.

"In general, the majority of the state is in a health care provider shortage," she said. "There's not enough to go around in all areas of providers in general, especially in the rural, remote areas.

"You're probably not experiencing that if you live in Hattiesburg, Jackson or on the Coast, but if you're in the rest of the state — you're experiencing a provider shortage."

Merit Health Wesley has taken a number of approaches to attract nurses to its staff, said Phebe McKay, chief nursing officer.

"We continue to search for both new and experienced nurses," she said in an email. "We take a proactive approach to staying fully staffed, creating positions that are both competitive and that support nurses' schedules outside of work.

"Nursing is not an easy profession. Our turnover is higher. There's burnout. You've got to work weekends and holidays. It's stressful."

The baby boom is affecting the nurse employment rate as well. Older nurses are retiring, leaving open positions.

Karen Sicard, dean of William Carey University's School of Nursing, said when the economy is good, nurses retire.

"When we had a bad economy, nurses were coming out of retirement," she said. "But no matter the state of the economy, we always have sick people."

Although, according to Story, nursing school enrollment has increased 3.6 percent in the country in the past couple of years, it still has not increased enough to meet the needs of the baby boomers or the changing landscape of health care.

In Mississippi, mental health nurses are a critical need.

"We saw a swing from mental health being a stigma and people not seeking care to now it being embraced," Story said. "As we've seen that swing, our health care provider needs have increased, but our health care providers have not."

Story said 111 million people in the United States live in an area with a mental health care provider shortage, and that problem is probably worse in a rural state like Mississippi.

"University of Southern Mississippi is one of only two schools in the state that has psychiatric mental health nurse practitioner (programs)," she said. "I've seen enrollment in our program increase in the last three years, but we've had to cap it because of lack of faculty."

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Southern Miss nursing students Katie Sullivan and Mary Parker Haynie speak with freshman Ashley Cannon during the "That's My Major" Fair on Tuesday in Southern Miss' Thad Cochran Center. The fair has senior and junior students advising freshmen and sophomores to help them pick a specific major.
(Photo: Susan Broadbridge/Hattiesburg American)

Plenty of applicants, not enough faculty

Story said nursing faculty shortages continue to be at a crisis level. Many nurses don't want to leave a lucrative profession to teach for lower pay.

"The faculty vacancy rate is 7.9 percent across the county and that's expected to double or triple in the next 5-10 years," she said.

Southern Miss nursing officials have taken steps to alleviate the faculty shortage in their programs. They've streamlined the bachelor of nursing to Ph.D. program track to 3½ years.

They've put the Ph.D. program entirely online and they've gotten a grant that pays 100 percent of tuition and books for anyone wanting to return to school to become a nursing teacher.

"If we can't fix the faculty shortage, none of the other shortages will be fixed," Story said.

As faculty members become available, more students will be able to attend and graduate from nursing school. Then it's a question of keeping them in the field.

At Merit Health Wesley, retention of nurses is a priority. The hospital offers them benefits such as complimentary massage therapy, a Serenity Room for relaxation, a Prayer Garden and free meals on Thursdays.

"These nursing shortages — whether it's faculty or provider shortages — impact patient care," Story said. "If we don't right the ship, that patient care can't help but be further impacted."